Schizophrenia is a debilitating disorder affecting the psychic and motor functions of the brain. It is typically diagnosed in individuals in their early to mid-twenties and symptoms include hallucinations and delusions or at the other extreme, anhedonia or social withdrawal. Across the spectrum, the symptoms are indicative of cognitive impairment and functional disabilities. Notwithstanding improvements in antipsychotic treatments, current therapies, including typical (haloperidol) and atypical (clozapine or olanzapine) antipsychotics, have been less than acceptable and result in an extremely high rate of noncomplicance or discontinuation of medication. Dissatisfaction with therapy is attributed to lack of efficacy or intolerable and unacceptable side affects. The side effects have been associated with significant metabolic, extrapyramidal, prolactic and cardiac adverse events (Lieberman et al., N. Engl. J. Med. (2005) 353:1209-1223).
While multiple pathways are believed to be involved with the pathogenesis of schizophrenia leading to psychosis and cognition deficits, much attention has focused on the role of glutamate/NMDA dysfunction associated with cyclic guanosine monophosphate (cGMP) levels and the dopaminergic D2 receptor associated with cyclic adenosine monophosphate (cAMP). These ubiquitous second messengers may be responsible for altering the function of many intracellular proteins. Cyclic AMP is thought to regulate the activity of cAMP-dependent protein kinase (PKA), which in turns phosphorylates and regulates many types of proteins including ion channels, enzymes and transcription factors. Similarly, cGMP may also be responsible for downstream regulation of kinases and ion channels.
One pathway for affecting the levels of cyclic nucleotides, such as cAMP and cGMP, is to alter or regulate the enzymes that degrade these enzymes, known as 3′,5′-cyclic nucleotide specific phosphodiesterases (PDEs). The PDE superfamily includes twenty one genes that encode for eleven families of PDEs. These families are further subdivided based on catalytic domain homology and substrate specificity and include the: (1) cAMP specific, PDE4A-D, 7A and 7B, and 8A and 8B; (2) cGMP specific, PDE 5A, 6A-C, and 9A; and (3) those that are dual substrate, PDE 1A-C, 2A, 3A and 3B, 10A, and 11A. The homology between the families, ranging from 20% to 45% suggests that it may be possible to develop selective inhibitors for each of these subtypes.
The identification of PDE9 was recently reported and was distinguished from other PDEs on the basis of its amino acid sequence, functional properties, and tissue distribution (Fisher et al., J Biol Chem., 1998, 273(25): 15559-64). PDE9V is encoded by two genes (PDE9A and PDE9B) and is cGMP specific. To date, at least 20 different splice variants have been discovered (PDE9A1-PD9A20) in human and in mouse (Guipponi et al., Hum. Genet., 1998, 103(4): 386-92). Structural study of PDE9A have been shown that its cDNA of the different splice variants share a high percentage of amino acid identity in the catalytic domain (Rentero et al., Biochem. Biophys. Res. Commun, 2003, 301(3): 686-92). However, despite its highest specificity for cGMP among all the PDEs, PDE9A lacks a GAF domain, whose binding of cGMP usually activates catalytic activity. Besides its expression in the kidney, spleen, and other peripheral organs, PDE9 is widespread through the brain in mice, rats and humans with high similarities of expression in striatum, cerebellum, olfactory bulbs, amygdala and midbrain (van Staveren et al., J Neurocytol 2002, 31(8-9): 729-41). The expression is mainly detected in neurons and astrocytes.
Inhibition of PDE9 is believed to be useful in the treatment of cognitive deficit associated with neurodegenerative and psychiatric disorders and a wide variety of conditions or disorders that would benefit from increasing levels of cGMP within neurons, including including Alzheimer's disease, schizophrenia, and depression.